Senior Centers, Nursing Homes Respond to Increased Diversity of Older Population

By Tara Bahrampour
Washington Post Staff Writer
Wednesday, August 26, 2009; B01

Dvoira Rososhanskaya wheeled her chair through the Hebrew Home of Greater Washington, past the bathrooms that say "tuyalet" in Cyrillic letters and the bookcase full of Russian translations of Agatha Christie and Arthur Conan Doyle. A Russian writer had just read his short stories to a group of senior citizens from the former Soviet Union, and Rososhanskaya, 87, had loved it.

"It's very important for me to be among Russian speakers," said the onetime preschool teacher from Ukraine who earned three medals digging trenches near Stalingrad during World War II. "Everything he was telling and reading from his book corresponded with things I'd gone through in my life."

Rososhanskaya is one of 42 Russian-speaking residents at the Rockville facility, which is responding to what experts believe will be a growing demand for multicultural offerings at senior centers and nursing homes as America's elderly population becomes increasingly diverse.

In the Washington area, which has residents from 193 countries, there are retirement homes that cater to a single ethnic group, such as Chinese or Korean, serving their native foods and hiring staff who speak their native tongues. Now some general population facilities are also tailoring their services to an increasingly diverse clientele.

"Everyone is going to have to learn more about various ethnic and cultural sensitivities, because the marketplace of aging is getting more diverse," said Larry Minnix, president and chief executive of the American Association of Homes and Services for the Aging. "I think, over the next five to 10 years, you're going to see a lot of attention paid to this."

About 10 percent of people 65 and older in the United States are foreign-born. The Pew Research Center estimates that by 2050, that figure will rise to 20 percent, with the total number of elderly immigrants quadrupling to about 16 million.

The movement to serve this population seems to be taking root in individual facilities that see a need rather than coming as a top-down corporate decision. Representatives for large national organizations such as Leisure World and Sunrise Senior Living said they knew of no such programs in their organizations.

Ian Brown, chairman of the diversity and inclusion council at Erickson Living, a retirement organization with 23,000 residents nationwide, said multiculturalism sometimes begins with the employees, who increasingly come from countries such as Nigeria, India and the Philippines.

"They go home to their own parents and say, 'Hey, this is something that celebrates you and celebrates me, and I think this would be a great place for you to be,' " Brown said, adding that the facility where he is based, in Illinois, hosts special meals that showcase staff members' homelands.

In some ways, moving into a retirement facility can be a bigger culture shock than immigration itself. While younger immigrants usually learn some English and adapt to American culture for school and work, those who arrive after retirement often have less incentive to assimilate. Staying at home and communicating through younger family members, they can cling to their language and customs for decades.

But with fewer old-world extended families to care for them at home, many face the prospect of nursing homes where the language, food and signs are unfamiliar and where staff members and fellow residents might know nothing about their backgrounds.

On top of that, in many cultures, separating an old person from the family is taboo. Leaders of Muslim communities have approached Minnix's organization looking for facilities, but also expressing ambivalence. "There's a bias -- if your mother has to be put somewhere, then you're not fulfilling your responsibility," he said.

There are also fewer facilities catering to more recent arrivals. "If you're, say, kosher Jewish, there's plenty of places," Minnix said. "But what do you do if you're Pakistani? I don't think we've got any disciplined, well-thought-out answer to that."

Jasmine Borrego, president of Telacu Residential Management, which provides housing for the elderly and disabled in Southern California, said that in recent years more Hispanics are moving into retirement homes.

"In the past 10 years, it's evolved, and it's not so much 'We don't want Mom and Pop to live with us,' it's about what's best for Mom and Dad," she said. "It's really a cultural shift."

Making everyone feel comfortable can present cultural obstacles for even the best-intentioned facility, however. Minnix recalled a Native American nursing home resident who shut himself in his room and stopped eating, mystifying his caretakers until they discovered the cause.

"In the lobby was a picture of, I think, an owl, and that symbolized, for him, death, and it took a while to figure out that that was the problem," Minnix said. The owl was removed, and the man resumed eating. "What we don't know are the subtle barriers to culture and religion that are going to be an issue over the next few years."

At the same time, he said, delegations come from other countries to learn how elder care is done here. If retirement communities become more prevalent abroad, they might become more palatable for future immigrants to the United States.

City- and county-run organizations, as well as private ones, are increasing their multicultural offerings. At the Rockville Senior Center, Hispanic, Chinese, Korean and Iranian immigrants participate in a range of activities in their native languages, and the center is paying for staff to learn foreign languages.

In the center's cafeteria Friday, Chinese women rehearsed a fan dance, then joined several dozen compatriots for exercises based on chi-gong and a Chinese lunch of tofu, rice, chicken and noodles.

"I thought it would be harder to find Chinese culture in America," said Yi Hua Wang, 73, who moved to Gaithersburg from Beijing two years ago. "I like America; I can do the twist," she said, swiveling her hips a bit. "But I cannot forget my own culture."

Down the hall, women from Colombia, Bolivia, Peru, and El Salvador played bingo. Felipa Gochez, 70, of El Salvador won the game, then joined the group doing chi-gong. She could not understand the instructor on the videotape, who explained in Mandarin that slapping your face and neck prevents wrinkles and hitting your shoulder calms worries. But, she said, "It does me a lot of good."

At the Hebrew Home, the Russian program started in 2006 as more Russian speakers moved into the home, the result of a wave of immigration in the late 1980s and early 1990s as the Soviet Union collapsed.

Sophia Presman, an immigrant from the former Soviet republic of Moldova, was hired as the home's first Russian recreation coordinator. She orders Russian books and magazines; arranges for Russian-speaking guests to talk with residents about literature, history, and politics; organizes bingo in Russian; and brings in a Russian psychotherapist to meet with residents.

Natives of Russia, Ukraine, Belarus, Lithuania, Moldova and Armenia quickly took a new interest in their surroundings. Word spread and the Russian-speaking population there quadrupled.

It was something many would never have foreseen. "Nursing homes in the Soviet Union were like concentration camp," Presman said. "Well, not as bad, but almost equivalent to it. The conditions were despicable. To put someone in a nursing home, it was absolutely last resort. It meant that no one would take care of them."

Rososhanskaya, the former preschool teacher, agreed. Back in her home town of Zhitomir, she said, "it was absolutely inconceivable to me to consider that I would ever be placed in a nursing home." But here, "I think it's the smartest idea. I'm very comfortable, very well treated, and I feel that my life is not lost."

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